The use of nutritional supplements in diabetes

Dietitian, Esteé van Lingen, educates us on nutritional supplements, what ingredients to look for and highlights the benefits of using Lifegain® Advanced Nutritional Supplement.


Before we can get into why nutritional supplements could be beneficial for people living with diabetes or not, we need to first understand the difference between meal replacements and nutritional supplements.

We also need to understand the ingredients nutritional supplements may contain and why each one is important. This will assist you in making an informed choice before buying a nutritional supplement.

Nutritional supplement vs meal replacement

A nutritional supplement is an extra supplement that you can take on top of your meals to add extra nutrients your body may be lacking. This can be taken with meals or in between meals to add extra nutrition where needed. Lifegain® is an example of a nutritional supplement.

Meal replacements, on the other hand, are as the words say, a replacement option instead of having a meal. You will have this instead of a meal. An example of this is a Meal Replace Shake like Replace® Diabetic.

Ingredients in nutritional supplements

When looking at the different ingredients that nutritional supplements contain, we start with protein then carbohydrates and lastly fats.

Protein

Protein is one of the most important macronutrients needed for the body to function. The word protein comes from a Greek word meaning primary or holding the first place and that’s why they say protein is seen as the building blocks of the body. Because it is an essential nutrient, you need to consume it daily whether it’s from an animal or plant source.

Protein helps stabilise blood glucose levels when eaten together with a carbohydrate so that the impact isn’t as high on blood glucose compared to eating carbohydrates alone.

As you get older, you quickly start to lose muscle and since most people cut their protein intake (due to various reasons), there is nothing to help sustain muscle mass. To then try and rebuild muscle when you are older is much harder compared to when you were young.

The average person needs at least 0,8g protein per kg of bodyweight per day to sustain basic functions. For example, a person who weighs 50kg will need at least 40g of protein per day.

If you are training a lot or want to build muscle, you would need at least 1,2 – 2g of protein per kg of bodyweight per day. For example, a person who weighs 50kg will need 60 – 100g of protein per day.

It’s interesting to know that many people don’t even reach 1g of protein per kg of their bodyweight per day through meals alone.

Note: This doesn’t mean 120g meat is equal to 120g protein. For example, 1 chicken breast of 120g contains 28g of protein. 

Carbohydrates

Out of the three macronutrient types, carbohydrates have the most marked effect on postprandial blood glucose response (blood glucose level after a meal).

Carbohydrates provide the body with energy and can be found in various foods, including bread, pasta, cereals, rice, potatoes, sweet potato, butternut, fruits and dairy products.

You should also then distinguish between healthy (unrefined) and unhealthy (refined) carbohydrates. Unrefined carbohydrates are minimally processed and eaten as close to their natural state with the grain and germ still intact.

Refined carbohydrates are processed to get a softer, more available carbohydrate. The end results: quicker absorption and release into the bloodstream, causing a spike in blood glucose levels.

One starch portion is equal to 15 grams of carbohydrates. So, depending on how well-controlled your glucose levels are, your gender and other chronic conditions, you don’t want to consume more than two starches in one meal.

The lower the carbohydrate content of a certain meal is and the less processed it is, the lower impact it will have on blood glucose levels. Therefore, it’s encouraged to rather eat a lower amount of carbohydrates in a meal and when consumed, choose the unrefined options instead.

You should also rather spread it out evenly throughout the day instead of eating no carbohydrates the whole day and then eating three servings at night.

Fats

Fat is the final macronutrient. It is also a source of energy but more importantly it assists in keeping the cell walls healthy as well as assists the body in making healthy hormones.

When consuming fats, you want to consume more healthy fats (omega-3) versus unhealthy fats (saturated fats, trans fats, and cholesterol).

Omega-3 helps reduce and prevent inflammation in the body as well as keep the cell walls healthy for the body to properly absorb nutrients and medication into the cells making blood glucose control more effective.

Lifegain® Advanced Nutritional Supplement

When looking at Lifegain®, it contains 4g of carbohydrates per serving and 15,3g of protein which makes it low in carbohydrates and higher in protein.

Furthermore, Lifegain® has a protein blend that contains three sources of protein (soy protein, whey protein isolate and milk protein isolate) that helps with muscle recovery. This is very helpful in the case of an active person living with diabetes or in the elderly to assist in maintaining muscle mass.

This makes it a good substitute for a person with diabetes that needs to consume a small amount of carbohydrates and still keep blood glucose levels stable without it dropping too low or going too high. Provided it fits within your nutrient requirements and/or consulting with your healthcare provider or dietitian first before starting on anything.

Glutamine

Lifegain® also contains glutamine that assists with immune function and gut health which is important. Uncontrolled blood glucose levels reduce immune function and makes a person with diabetes more susceptible to infections. If your gut health is not great, you can’t absorb the nutrients that you do consume properly.

Glutamine improves gut health to assist with digestion and absorption of nutrients. With the improvement in absorption, it may then in the long run assist with weight loss when combined with a balanced lifestyle and consumption of the correct amounts of healthy foods.

Vitamins and minerals

Vitamins and minerals are essential to assist with muscle functions as well as boost your immune system and provide you with energy. The combination of the vitamins and minerals found in Lifegain® includes calcium, magnesium, vitamin D3, zinc, iron and vitamin C. Again, these help protect your muscles, bones and boost immunity.

Free from intolerant ingredients

Lifegain® is free of gluten, lactose, cholesterol, trans fat and preservatives which makes it ideal for someone suffering from gluten or lactose intolerance or anyone with sensitivities to preservatives. This also means that there is no added sugar and no refined carbohydrates.

How to make a nutritional supplement part of a healthy balanced diet

If you are a very busy individual (especially someone living with diabetes) that tends to miss meals as you don’t have time to eat a proper cooked meal, have certain food preferences, or you don’t have a big appetite to eat a large meal, a nutritional supplement will then be an ideal option for you.

Lifegain® only has 507kJ per serving so it will work well as a snack in between meals or used as a base of a light meal. If you want to increase the nutrients, you can do so by mixing it with low-fat milk instead of water or eating a fruit and/or raw vegetables on the side. Or you can make a smoothie out of it with unsweetened plain yoghurt or low-fat milk, one fruit serving, raw vegetables and a fat, such as almonds and chia seeds.

Since Lifegain® has 15g of protein per serving, it has about the protein content of half a chicken breast making it an ideal nutritional supplement even for someone that has kidney issues. This only counts as long as it is made with water and the protein intake for the rest of the day is restricted. Any additions or changes should of course only be made under the guidance of your healthcare professional.

A nutritional supplement is recommended for the elderly who might have a poor nutritional status due to not cooking nutritious meals as often and especially for the elderly who also have diabetes. For example, instead of eating two slices of bread, they can have one serving of Lifegain® once or twice per day and then add fresh vegetables and protein as needed. Thus, making it more balanced and sustainable in the long term.

Kidney problems and protein

A low protein diet is recommended for people with kidney problems and renal disease. The protein requirements for people with renal disease is 0,6 – 0,8g per kilogram of bodyweight but this depends on the stage of kidney disease.

Protein increases the pressure in the kidney tubes by attracting more water as it passes through them, thus leading to increased strain on the kidneys and increased loss of renal function. People on dialysis have higher protein requirements due to the protein loss during the dialysis process.

The function of the kidneys includes: removing waste products from the blood, maintaining fluid balance in the body as well as controlling blood pressure. When the kidneys are failing, damaged or only one of them is functioning, they can’t perform these essential tasks.

Seek professional guidance

Before taking any nutritional supplement or meal replacement, please consult your dietitian first to see if it would be suitable for you and how it can be worked in as part of a healthy balanced diet and lifestyle.

For people with kidney problems (a complication of diabetes), protein does need to be restricted depending on kidney function and you should contact your dietitian to calculate your specific needs and work it into a balanced and sustainable diet.

 

Estée van Lingen is a registered dietitian practicing in Randburg and Fourways, Gauteng. She has been in private practice since 2014 and is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.

MEET THE EXPERT


Estée van Lingen is a registered dietitian and has been in private practice since 2014. She is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.


Header image by Adobe Stock
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DSA News Winter 2023

– DSA Western Cape News –

BOOK YOUR SPOT TODAY!! Email [email protected]

 A BIG THANK YOU TO AQUELLE


“Have a Heart for Diabetes” is a Diabetes Awareness Campaign which Aquelle and Diabetes South Africa promoted during October 2022 to March 2023.
Aquelle Company supported Diabetes South Africa during the 2nd half of 2022 and 1st quarter of 2023 and sponsored 2000 free Diabetes South Africa memberships.  They also donated 2000 Aquelle drawstring bags and thousands of bottles of Aquelle Water to encourage people with diabetes to drink more water. Margot Mc Cumisky, National Manager of Diabetes South Africa says: “Aquelle Company and staff have given Diabetes South Africa amazing support and encouragement by donating funds and driving the “Have a Heart for Diabetes” campaign to create more awareness around diabetes.  They have done what no other company has done during our 54 years since we started Diabetes S.A. in 1969. We only wish that we could receive similar support from other companies and Foundations.  People with diabetes need the education, motivation and support that our organisation provides, but for us to continue providing our services we need the kind of help that Aquelle has offered Diabetes S.A.”

Diabetes Wellness Day


DSA Western Cape handed out 75 aQuellé sponsored DSA membership packages to patients who attended a Diabetes Wellness Day at the Retreat Community Centre in November 2022.

The patients were delighted with the DSA membership benefits which would not have been possible without the generous sponsorships from aQuellé, Pharmaco, Spec Savers and Cape Mohair.

Diabetes picnic


A Diabetes picnic was held in the park held in November 2022 at Green Point Urban Park. There were several speakers including Nicholas from City Bowl Gym, Heinrich and Lynette Grobelaar, two paramedics from Wellness Excellence, and Daniel Sher, a psychologist. It was a beautiful sunny day with lots of shade to picnic under the trees and listen to these amazing people talk about diabetes.

– DSA Port Elizabeth News –

R10 000 donated to DSA Port Elizabeth


Lynne Vorster, one of our branch management board members, invited us (representatives of DSA Port Elizabeth) to attend the EC Teen Gala Event that was held in the Feather Market Centre. They presented us with a small gift box and what a lovely surprise it was when saw R10 000 donation.

Malabar Diabetes Wellness Meeting


At the April Malabar Diabetes Wellness Meeting, Dr Harshil Ranchod, a dentist, explained all about How to maintain sound oral health in the diabetic patient.

Dr Ranchod’s grandmother, Mrs Shanti Ranchod, and parents came to support him and were honoured guests at the meeting. His grandmother who, at almost 90 years old, is the oldest lady in the Indian community. See the photo of Surendra Daya and these four special people.

Sweet beats of music


Angelo Du Plessis, a registered counsellor, had all the people at the Springdale March Diabetes Wellness Meeting enjoying and learning about the benefits of exercise and music.

Worker’s Day treat


On Workers Day, we, the volunteers on the Port Elizabeth Management Board, treated themselves and their partners to a most delicious brunch at Heaven’s Kitchen. After brunch, we gathered round a large table to have our first live management board meeting since the start of COVID. It was a great time of socialising and really getting to know each other and our families.

Humansdorp Hospital DSA membership handout


Representatives of DSA Port Elizabeth travelled to Humansdorp Hospital in the Eastern Cape to handout DSA membership packs, sponsored by aQuellé and DSA.

The Community Liaison Officer for Nutrition, Elizabeth and Martin Prinsloo, and Nomsa Satula (Nutrition Manager/Dietitian).
The Community Liaison Officer for Nutrition, Elizabeth and Martin Prinsloo, and Nomsa Satula (Nutrition Manager/Dietitian), Kouga Sub-District showing the packed aQuellé goody bags and the bottles of aQuellé water that were all crowded with us in Nomsa’s small office.
news
Elizabeth, Nomsa and Martin outside the hospital.
Some happy recipients from the Weston suburb of Humansdorp.
Some happy recipients from the Weston suburb of Humansdorp with their aQuellé goody bags.

Collection of aQuellé goody bags


Two members collected their aQuellé goody bags at the April Port Elizabeth Diabetes Wellness Meeting.

– DSA Pretoria News –

March Diabetes Wellness Support Group Meeting


What a powerful, informative and interactive Wellness Support Group gathering on 25 March 2023. A note of appreciation to members who showed up and to our guest speaker, Christine Steyn who shared her knowledge and demonstrated the use of various Fora glucometers as well as high blood pressure machines.

We were all empowered with the information on how to link them to cell phones and the benefits thereof. Attendees had their blood glucose levels tested and blood pressure measured. Christine is willing to help each person who needs individual help on these tech savvy meters.

April Diabetes Wellness Support Group Meeting


A special note of appreciation to all people who showed up at the Diabetes Wellness Support Group Meeting on 22 April. We were all empowered by Bernadine Blom, a dietitian. Her interactive and informative session highlighted how to manage diabetes through a healthy diet. We learnt how food choices and quantities can affect our health condition. An additional nugget was to learn of the benefits of taking the vitamin B12 and vitamin D supplements for those who use Glucophage or metformin.

If you’re interested in diabetes or living with diabetes, make an effort to attend the once a month support group meeting, there is always something new to learn. Knowledge is power.

May Diabetes Wellness Support Group Meeting


The DSA Pretoria Wellness Support Group would like to thank all members who braved the icy cold weather on 20 May to listen, engage and tap on vast, practical knowledge on diabetes by diabetes nurse educator, Sr Louise Pywell.

We all benefitted from the extensive expertise and knowledge about the care of people living with diabetes and learnt about diabetes and how to live a healthy life with this health challenge.

The information covered a broad spectrum of issues on appropriate diet, monitoring of blood glucose, administration of insulin, hypoglycaemia and hyperglycaemia. We were also informed of newest techniques and interventions available.

For further information, you may contact Sr Louise: +27 82 451 0706

Please diarise the next Wellness Meeting on 24 June 2023. Each one bring one!

A call for volunteers


Diabetes SA is primarily a volunteer organisation and relies heavily on people living with diabetes and their families who pool their talents, share their knowledge and experiences and give of their time to help each other.

You too could be a great organiser and get everyone off on a big walk or you may, equally valuable, be a friendly face that is willing to initiate a support group, or you may equally have a valuable skill.

❤️ DSA Pretoria branch is looking for volunteers to assist with the spreading of awareness of diabetes in communities. Start-up wellness support groups, guidance and booklets will be provided.

❤️ Someone with a little time on their hands to assist with admin. You will need a laptop and internet.

❤️ We would love to be assisted with social media awareness.

❤️ People who are keen to start support groups in their areas. Guidelines and start-up materials are available

❤️ We are looking for young and old vibrant people who have a passion for sharing information and creating awareness.

❤️ People who could be coached for two years to take up various roles in the near future.

The majority of us are volunteers and not paid workers. Most of us are retirees who do not have offices and work from home.

Anyone is welcome to join the group; one can become a friend of the group and indicate what services one is willing or capable of assisting with.

For further information and to see where you may be able to assist people living with diabetes, please kindly contact Liz by email at: [email protected]

FUTURELIFE® Skinny Crêpes

Discover a nutritious and delicious meal option with FUTURELIFE®  Skinny Crêpes recipe – so easy to make and so full of goodness.

Serving: Makes about 8 crêpes

Ingredients

  • 4 egg whites
  • 1 cup FUTURELIFE® ZERO Smart food™
  • 1/2 cup light coconut milk
  • 1 cup water
  • Pinch of salt
  • 1/2 teaspoon stevia powder
  • Berries to serve

Method

  1. Add all the ingredients to a bowl and gently whisk together until mixed (you may need to add more FUTURELIFE® Zero Smart food™ or more water so that the batter is very runny).
  2. Spray a non-stick pan with some Spray ‘n Cook and when the pan is very hot, spoon a tablespoonful of the batter onto it and flip over after 45 seconds.
  3. Serve with berries.

For more information on the product used in this recipe visit: futurelife.co.za


NUTRITION INFO

Makes about 8 crêpes:

Energy Protein Carbohydrates Fat
Crêpes 361KJ  5g  8g  3g
With 100g Strawberries 483KJ  5g  14g  3g

Ode to Ozempic and friends

Dr Angela Murphy explains why people are using Ozempic off-label for weight loss resulting in a shortage for people with diabetes who need it for glucose control, not only in SA but around the world.


The twin pandemics of obesity and Type 2 diabetes have created a need to find a common management pathway. A healthy lifestyle is essential; no medication will override a poor diet or lack of exercise. However, for many people living with diabetes, medications are needed to control blood glucose levels and lose meaningful weight.

Definition recap

Diabetes – diagnosed when fasting blood glucose is ≥7.0mmol/L, and/or two-hour post glucose drink test is ≥ 11.1mmol/L and/or HbA1c >6.5%

Obesity – body mass index (BMI) which is calculated by dividing height squared into weight: > 30kg/m2 = obese and                                                                                                                                             25-30kg/m2 is overweight

It’s important to measure waist circumference in patients to ascertain the degree of visceral fat. It’s this fat which causes most of the metabolic complications, especially diabetes.

A novel hormone pathway

The incretin hormones are produced in the cells lining the small intestine in response to digested food entering there. These hormones alert the pancreas to make insulin to control blood glucose at mealtimes. This system has been found to be sluggish in Type 2 diabetes, so medications were developed to improved incretin hormone levels.

There are two main incretin hormones in the human body: glucagon-like peptide 1 (GLP-1) and gluco-inhibitory peptide (GIP).  The medications produced to increase GLP-1 levels are called GLP-1 receptor agonists and have made a significant impact on the treatment of both diabetes and obesity. They do this by:

  1. Stimulating the pancreas to increase insulin.
  2. Blocking the liver from producing glucose.
  3. Directly inhibiting the appetite centre in the brain.
  4. Decreasing how quickly the stomach empties which means a person feels full for longer.

In addition, some of the GLP-1 medications have been shown to protect the heart.

The GLP-1 receptor agonist medications

Most GLP-1 receptor agonists are given as a subcutaneous injection as they are rapidly destroyed in stomach acid. However, oral forms are now available overseas.

GLP-1 receptor agonists registered in South Africa for diabetes

  • Byetta (exenatide) – This was the first GLP-1 receptor agonist in South Africa. It’s given as a twice daily injection within 60 minutes of breakfast and dinner. It’s effective in lowering blood glucose after meals but doesn’t have much effect on weight.
  • Victoza (liraglutide) – This is given as a daily injection starting at a dose of 0.6mg daily and increasing to 1.8mg daily and has shown significant improvement in weight loss.
  • Trulicity (dulaglutide) – This is a weekly injection given with a single-use device so the needle isn’t visible. It comes in one dose of 1.5mg weekly and has excellent glucose lowering properties but doesn’t result in significant weight loss.
  • Ozempic (semaglutide) – This is a weekly injection where the dose is titrated from 0.25mg to 1mg depending on the blood glucose levels. Ozempic also lowers blood glucose levels effectively and has shown good weight loss.

GLP-1 receptor agonists not available in South Africa

  • Rybelsus (oral semaglutide) – This is the only oral GLP-1 receptor agonist available as a daily pill either in a 7mg or 14mg dose.
  • Mounjaro (tirazepatide) – Strictly speaking this is a dual incretin agent (it acts on both GLP-1 and GIP receptors). Clinical trials have shown it to be superior to all the above GLP-receptor agonists in controlling blood glucose and weight loss in patients with Type 2 diabetes.

GLP1-receptor agonist medications and weight loss

Registered in SA

Only one GLP-1 RA is registered in South Africa for weight loss:

Saxenda (liraglutide) – You will note it’s the same product as Victoza but when used for weight loss it’s marketed in larger doses and under a different name.

Clinical trials showed that meaningful weight loss was achieved at a dose of 3mg daily, significantly higher than the doses used to treat diabetes. The best results were achieved in subjects who had already lost at least 5% weight on calorie restriction before starting Saxenda. Then over the course of 56 weeks they lost a further 6kg of body weight.

Not registered in SA

Ozempic (semaglutide) is not registered for weight loss in South Africa. The molecule, semaglutide, is registered overseas for weight loss under the name Wegovy.

As has been seen with liraglutide, Ozempic needs to be given in higher doses for weight loss – up to 2.4mg weekly. The STEP clinical trials demonstrated weight loss of approximately 10 – 15%. STEP 4 particularly looked at what happened after the medication was stopped: after using semaglutide 2.4mg weekly for 20 weeks, subjects had treatment discontinued and had regained 6kg by the end of the trial. This emphasises the chronic nature of obesity management.

People are using Ozempic off-label for weight loss, including celebrities who posted on social media of its effectiveness. This, unfortunately, resulted in a run on the drug and stocks plummeted. The tragedy of this is that people with diabetes using Ozempic for glucose control have struggled to get their supply; a problem both in South Africa and around the world.

Mounjero is not yet registered for weight loss but there is no doubt that it will be (possibly under a different trade name) as clinical trial results show subjects are shedding up to 20% of body weight. This is the most effective weight loss medication to date.

GLP-1 receptor agonists side effects

The most common side effects are gastro-intestinal: nausea, vomiting, diarrhoea, abdominal cramps, and heartburn. These side effects can be reduced with the following measures:

  1. Eat small portions.
  2. Avoid fatty meals.
  3. Chew food thoroughly.

These medications should not cause hypoglycaemia (low blood glucose) but if they are being added to insulin or other oral diabetes medications that can cause hypoglycaemia (sulphonylureas), low blood glucose levels must be watched for. The other medications can be decreased in dose.

A history of pancreatitis is a contra-indication to using these medications and they are not registered for use in pregnancy or when breastfeeding.

If a person has a history of thyroid cancer, they may be advised not to use GLP-1 receptor agonists. However, it’s important to understand that this risk is theoretical based on rat studies. No case of thyroid cancer due to these medications has been described in humans.

Medical aid reimbursement

Many medical aids do reimburse for this group of medications for people living with diabetes. Certain criteria must be met, for example, glucose levels not well-controlled on other medications and an increased weight.

Your doctor will usually have to motivate to get cover under chronic benefits. Note: medical aids don’t recognise obesity as a chronic condition and will not cover medication to treat it.

The cost of Saxenda at a dose of 3mg daily is over R4 000 per month. This is a significant financial commitment. It’s vital to remember that Saxenda’s effects will be lost if the medication is stopped. Treating obesity should be approached in the same way as treating diabetes or hypertension: as a chronic condition.

The challenge

Managing the combination of obesity, diabetes and pre-diabetes can be frustrating. A balanced lifestyle is the cornerstone to this, but it’s difficult for people to constantly be told to eat less and move more and still see no meaningful changes.

There is a great need for a pharmacological intervention and the GLP-1 receptor agonists are a step in the right direction. However, their use is restricted by possible side effects, cost, and the need for them to be used as ongoing treatment.

It’s my opinion that the reason we fail to achieve meaningful and sustained weight loss is that there is a tendency to look for a cure for overweight or obesity. It’s a concern that many people will use GLP-1 receptor agonist medications for short periods and once they achieve some weight loss, or if lucky even their goal weight, they will stop. After some months weight regain will start and the perception will be that these drugs are no better than any weight loss agent that has come before.

The future

There is no doubt that the GLP-1 receptor agonists offer the best medical intervention for overweight and obesity to date. If they are used as part of a holistic approach to a healthy lifestyle then significant, sustained weight loss may be achieved. It remains to be seen if funders will reimburse for their use on chronic benefits and whether people will use them as a regular, chronic prescription drug.

Dr Angela Murphy qualified as a specialist physician in 2000 and joined the Department of Endocrinology and Metabolism at Charlotte Maxeke Johannesburg Academic Hospital. Currently she sees patients at Sunward Park Medical Centre. She retains a special interest in endocrinology and a large part of her practice is diabetes and obesity. She is a member of the Society of Endocrinology and Metabolism of South Africa and the National Osteoporosis Foundation and is actively involved in diabetes patient education. Living with diabetes in the family for 17 years has shown her that knowledge is power. Basic principles in diabetes must always be applied but people living with diabetes should also be introduced to innovations in treatment and technology which may help their diabetes journey.

MEET THE EXPERT


Dr Angela Murphy is a specialist physician and currently sees patients at Sunward Park Medical Centre. She retains a special interest in endocrinology and a large part of her practice is diabetes and obesity. She is a member of the Society of Endocrinology and Metabolism of South Africa and the National Osteoporosis Foundation and is actively involved in diabetes patient education. Living with diabetes in the family for 17 years has shown her that knowledge is power.


Header image by FreePik

Dario Leveroni – All in his stride

Despite travelling for work most of the year, Dario Leveroni manages to keep his Type 2 diabetes in check. He tells us how.


Dario Leveroni (75) lives in Port Elizabeth with his wife. He is a semi-retired marine engineering surveyor. 

Dario was diagnosed with Type 2 diabetes in 2015, at the age of 68, after consulting with his doctor as he was frequently thirsty which was out of the norm. He was prescribed metformin and other medication. “When I was diagnosed I weighed 80kg so immediately reacted and dropped to 62kg within one year,” Dario says.

In 2016, Dario was flying to Italy for his son’s wedding (and being Italian, the carbs were aplenty) so his doctor recommended going on insulin too. Since then he has stayed on insulin, which consists of insulin degludec and insulin aspart (Ryzode) and insulin aspart injection (Fiasp) as well as metformin.

Travelling

When Dario is travelling for work, he always gets his supply of medication beforehand and he tries to stick to a Mediterranean diet. A normal day of eating for Dario is as follows:

Breakfast: cappuccino, oats or crushed wheat flakes.

Lunch: mostly salads (except Sundays).

Lunch and dinner: red meat, chicken, fish, vegetables (mostly raw), legumes, vegetable cold soup (Gazpacho), vegetable soup, and pasta (limited to 50g only once a week).

“Sometime my management goes off the track when it can’t be helped due to the airplane food. Plus, the business lounge and hotel meals throw a spanner in works, but otherwise once again self-discipline comes in,” Dario explains.

Luckily, Dario’s work comprises a lot of walking and climbing, helping him to keep moving his body. But he also tries to gym every day, doing cardio and light weights, for at least an hour.

Dario attributes his good management to positive thinking and self-discipline. “I control what I eat and get plenty of exercise and gym everyday, time permitting. I now weigh between a constant 60kg and 62kg.”

Complication free

Dario is an advocate of the flu vaccine and takes it every year to prevent getting flu. He is proud that he has no other complications from diabetes thanks to his good management of his glucose levels and is happy to be involved with DSA Port Elizabeth where he gets good support from a like-minded community.

 

Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za

MEET THE EDITOR


Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on [email protected]


Header image supplied

The water element and winter

Veronica Tift enlightens us on how the water element plays a role in the winter season and how to achieve balance with this element.


Let me take you on a little journey, you’re sitting nestled by a warm, glowing fire, crackling away. The blankets wrapped around you are comforting and make you feel held. You have in your hand a warm soothing drink and your beloved pet is comfortably nuzzled in a little ball near your feet. Why does this sound so completely ideal, as the cold weather starts to settle around us?

Because deep down we know that winter is the time for this kind of rest and restoration. Winters are like that, a more inward and sensitive time; its natures resting season, quieten down, deep in the earth and the roots preparing for spring. This is also a great time for you to go deeper within yourself, resting, reflecting and looking for replenishment.

The water element and winter

Are you feeling a little more emotional these days, craving salty foods or maybe everything tastes a little too salty, possibly feeling more fearful, especially in the evenings you can feel the anxiety creeping in?

According to the Chinese Five Elements, winter is related to the water element. Winter is the season in which the water element is most dominant. The kidneys, adrenal glands and bladder are the organs associated with the water element and the winter season.

From a Traditional Chinese Medicine (TCM) point of view, people with deficient water energy may struggle to slow down, rest or relax. A balanced water element allows fluidity and flow, there is the ability to nourish and rest, not only for themselves but others. Both water and emotions are unpredictable, when flowing, all is well, but when blocked or stagnant, great pressure can develop, or disease can set in.

Water is amazing; of all the qualities that are needed for life on earth, water is in all living things, whether they live at the bottom of the ocean or the dry desert. Water has made life possible on earth. It is adaptable, taking shapes of its container, changing form with cold and heat.

Having a water element out of balance doesn’t mean drinking large quantities of water. While you need to look at the quality of your water, the intention in which you drink it and being mindful of how much you drink or don’t drink, there is more to this season and the water element.

The kidneys

In TCM, the kidneys house our jing or in the Western world this would equate to your DNA and longevity. The building blocks for physical vitality are responsible for our aging. Jing is also responsible for fertility and reproduction, growth and development. So, when you move against the flow of life, you are exhausting out your own precious life force.

Use your Jing wisely. Step into flow rather than against it, this does not mean being complacent, but rather spending time and energy on things that align with your true desire and authentic expression. Warm yourself emotionally with family and friends, doing things that bring you joy.

Overworking, stressful or traumatic events, overexertion, emotional stress, spending energy on things that drain you, poor diet and lack of sleep will all make it harder to handle the cold and feel balanced during the winter season.

The emotion fear relates to the water element. The kidneys and urinary bladder organs can reflect as we see when anxiety and chronic stress correlate in scientific literature to frequent urination or painful urination as well as pelvic pain. In Chinese Medicine, the stress is specific to the emotion of fear and urgency to release pressure.

The kidneys can be thought of as your batteries, they can give you horsepower that is needed to move towards your ambitions, but only when they are in alignment. The changing of each season can bring stress to the body and illness itself can give you the opportunity to re-evaluate your life.

Questions to ask yourself  

  • Am I over-reacting in situations and do these situations really require this much stress from me?
  • Do these actions align with my natural gifts, talents and interests? Does it feel like my authentic truth?
  • Is this the right time for me to act? Is this the season of my life for this intention to flourish?
  • Am I forcing anything, pushing past signs that this is not right and acting outside my authentic self.

Ways to balance the water element

These include resting, walking in nature, moving your body, journaling, meditation, prayer, eating whole foods that are in season, reducing alcohol and drug use, and prioritising sleep.

Be with feelings of grounding, breathe and feel your body. Bring love to your fear, have compassion for how hard it has been and send yourself some kindness. Listen to your authentic self and wisdom of your body, feel what feels right for you.

Winter diet

As you move into winter, it’s a good idea to shift your diet to create more heat internally. Fruits should be eaten less. Vegetables should be steamed or baked. Eat hearty vegetable soups with root vegetables like carrots, turnups and onions. Not forgetting warming spices like ginger root and garlic while cayenne pepper adds heat to your meals and warmth to your toes.

Cooked whole grains can also be an excellent staple in winter and roasted nuts can be a good snack. The most important thing is to listen to what your body is really telling you to consume. Brewing an herbal tea with ginseng roots or ginger are also traditional energisers.

Exercise in winter

Winter is the season of storage and preparation, take care of your activity level during the winter month and don’t run your batteries down. Move every day with stretching and dance, deep breathing and keeping that circulation moving. It’s a good time for indoor exercise like yoga, even a short practice can be beneficial.

The KD-1 point

The Yong Quan or KD-1 is the first point along the kidney meridian. It’s found between the second and third metatarsal bones on the sole of the foot. This point connects you directly with the vitality of the earth/yin energy and can aid in grounding and elevating energy, depending on what the body needs. It can bring up a deep well of energy or calm energy down, just like a fresh water spring emerges from the darkness of earth.

The KD-1 point gives access to the energy that is balanced and harmonious, and can be useful for fertility, easing anxiety and panic, restlessness, memory and insomnia. This is just one reflex point on the feet and regular treatments are key during the winter months.

Massaging this point, especially before bed, making contact with the earth when walking barefoot if possible and gripping your toes slightly in the earth while imagining energy flowing up into your body and reflexology are all great ways to keep your water element in balance.


References

www.noscoyoga.com/instagram

Inge Dougans Reflexology the 5 elements and their 12 meridian’s a unique approach; Thorsons

Haas. Dr Elson M. 1981, Staying healthy with the seasons

Axe, Dr Josh. 2021, Ancient Remedies for modern Life

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

MEET THE EXPERT


Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.


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Farewell Noy, farewell A4C

Sadly Noy Pullen passed away in February 2023, we look at all she achieved with the DSA project: Agents For Change.


When did Agents for Change start?

Agents for Change (A4C) began in 2007. The World Diabetes Foundation (WDF) began financially supporting Agents for Change in 2008.

In June 2015, Martin Wolf Andersen and Susanne Olejas from WDF Denmark, attended Agents for Change seminars in Western Cape and North West Province during a field visit.

Aim and the mission of A4C

Diabetes is a huge problem in South Africa (SA) and worldwide. There are over four million people diagnosed with diabetes in SA. The International Diabetes Federation reports that 50% of people with diabetes are undiagnosed worldwide.

Lack of trained healthcare providers in diabetes in SA is the most critical issue impeding the delivery of high-quality diabetes care. The aim of A4C is to train healthcare providers and other healthcare practitioners in diabetes in all provinces, including rural areas.

The programme creates awareness about the importance of lifestyle change when living with diabetes and reducing the risk of getting it.  Participants attend intensive two-day workshops, six months apart, where they learn about diabetes, how to manage it and prevent complications. They are also taught communication skills so that they can empower people living with diabetes for self-management. To do this, they are encouraged to change their own behaviour for better health.

In 2006, Noy Pullen relocated to Cape Town from Johannesburg where she met Buyelwa Majikela-Dlangamandla who was then a diabetes educator at Groote Schuur Hospital. They worked together on this project (A4C) through DSA since 2007 until January 2022.

Noy was also the editor of Diabetes Focus for many years. She had interest in diabetes and helping people as she had a family member with diabetes.

What are the greatest achievements for A4C?

The greatest achievements of A4C were training more than 2 000 healthcare providers. The majority of participants managed to change their own lifestyle, such as eating healthily, losing weight and doing physical activity.

Some of them started vegetable gardens. A4C supported them by providing them with tools, such as seeds, skipping ropes, measuring tapes, information booklets, etc.

During all trainings, A4C did practical food demonstrations, and everybody helped. Many said they thought that healthy eating was boring, but said they enjoyed the food during training and changed the way they prepared food at their homes.

A4C was recognised by the South African Department of Health and the trained healthcare workers reached more than 100 thousand people in the country.

What was Noy Pullen known best for?

Noy loved colour. Although she had a teaching qualification, she stopped teaching many years ago. She was also a make-up artist. Noy was an excellent article writer, interviewing people and writing their stories. She was a spiritual person who loved her family and was good at uniting them. She was a coach and teacher and encouraged people to be themselves and do their best.

How did she impact A4C?

A4C would never be the same without Noy. Her guidance helped and encouraged Buyelwa to use the guiding style of teaching rather than the old way of directive teaching. Noy had great influence and encouraged Buyelwa to write a diabetes book. She was accurate with bookkeeping and writing up of reports including financial reports to the sponsors.

A4C project stopped

Unfortunately, due to the sponsor stopping their financial support of A4C, the last A4C training was in January 2022.

Farewell Noy and farewell A4C; may your soul rest in eternal peace.


References

Agents for change WDF08-378 (project description)

Agents for change WDF11-590 (project description)

Agents for change WDF14-876 (project description)

Agents for Change: champions in the fight against diabetes in South Africa (Diabetes Voice, June 2009 | Volume 54 | Issue 2) http://www.idf.org/sites/default/files/attachments/2009_2_Pullen.pdf

HRH Strategy for the Health Sector: 2012 to 2017 (pdf) (http://www.ahp.org.za/files/1896/HRH%20Strategy%202012%20to%202017.pdf)

Gut health and diabetes

Mel Fourie explains the mechanisms of gut health in relation to Type 2 diabetes and what happens in your body when you eat nutrient-dense foods compared to empty calories.


Did you know that sugar consumption has gone from twenty teaspoons a year to twenty two teaspoons a day? When we primarily eat foods containing high sugar, dangerous trans fats, and low fibre, your body doesn’t know how to utilise these anti-biological nutrients which cause metabolic dysfunction and weight gain due to the proliferation of inflammatory gut bacteria. Your gut health (flora) becomes toxic spiralling your microbiome into dysbiosis, a term meaning imbalance.

Blood glucose imbalances, mood swings, weight gain, and sleep disturbances are just some of the many side effects that can happen when your dietary choices contain harmful ingredients.

At its very core, Type 2 diabetes can be understood as a disease caused by too much insulin, which your body secretes when you eat too much sugar.

Solving the problem – the quality of the food

Knowledge is power and presenting the problem this way is incredibly profound because the solution becomes immediately obvious. You can lower your insulin levels by reducing your dietary intake of sugar and refined carbohydrates thus improving your gut health.

This leads me to sharing a rather bold statement, that obesity and diabetes can’t be cured in a doctor’s office alone. The journey to healing diabetes begins on the farm, in the supermarkets, in the restaurants, in your kitchens, on your plates, and in your gut.

Depending on the quality of the food, it will have profoundly different effects. If you have, for example, broccoli or your favourite soda, they’re both carbohydrates, but they have very different effects in your gut and microbiome, as well as your biological responses.

Broccoli vs soda

To illustrate how this works, let’s follow a sequence of biological responses that occur as broccoli and soda enters your body.

Soda

Let’s begin with a few gulps of soda. Your gut quickly absorbs the fructose and glucose. The glucose spikes your blood glucose, starting a domino effect of high insulin and a cascade of hormonal responses that kicks bad biochemistry into gear. The high insulin increases storage of belly fat, increases inflammation, raises triglycerides, lowers HDL, raises blood pressure, lowers testosterone in men, and may contribute to infertility in women. Your appetite is increased because of insulin’s effect on your brain chemistry. The insulin blocks your appetite-control hormone leptin. You become more leptin resistant, so the brain never gets the I’m full signal. Instead, it thinks you are starving.

Your pleasure-based reward centre is triggered, driving you to consume more sugar fuelling a sugar addiction. The fructose makes things worse. It goes right to your liver, where it starts manufacturing fat, which triggers more insulin resistance and causes chronically elevated blood insulin levels, driving your body to store everything you eat as dangerous belly fat.

You may also get a fatty liver, which generates more inflammation. Chronic inflammation causes more weight gain leading to obesity. Anything that causes inflammation will worsen insulin resistance. Another problem with fructose is that it doesn’t send informational feedback to the brain, signalling that a load of calories just hit the body. Nor does it reduce ghrelin, the appetite hormone that is usually reduced when you eat real food. Now you can see just how easily your favourite soda can create biochemical chaos.

Broccoli

Let’s look at the digestive pathway of broccoli. As with your favourite soda, broccoli is made up primarily (although not entirely) of carbohydrates.

To clarify what that means, because the varying characteristics of carbohydrates will factor significantly into the contrast, carbohydrates are plant-based compounds comprised of carbon, hydrogen, and oxygen. They come in many varieties, but they are all technically sugars or starches, which convert to sugar in the body.

The important difference is in how they affect your blood glucose. High-fibre, low-sugar carbohydrates such as broccoli are slowly digested and don’t lead to blood glucose and insulin spikes, while table sugar is a quickly digested carbohydrate that spikes your blood glucose. Therein lies the difference.

Slow carbohydrates like broccoli heal rather than harm. When you eat broccoli there is no blood glucose or insulin spike, no risk of fatty liver, and no hormonal chaos. Your stomach distends sending signals to your brain that you are full. There is no triggering of the addiction reward centre in the brain. You also get many extra benefits that optimise metabolism, lower cholesterol, reduce inflammation, and boost detoxification.

The phytonutrients in broccoli boost your liver’s ability to detoxify environmental chemicals, and the flavonoid kaempferol is a powerful anti-inflammatory. Broccoli also contains high levels of vitamin C and folate, which protect against cancer. The glucosinolates and sulphorophanes in broccoli change the expression of your genes to help balance your sex hormones, reducing the risk of breast and other cancers.

This rather simple illustration clearly demonstrates that good nutrition is a fundamental cornerstone of well-being and gut health. When you shift your diet, you change your biology, so choose to eat well.

But what does it mean to eat well for good gut health?

Basically to eat whole foods in their most natural form, including all the colours of the rainbow every single day to ensure you are getting plenty of beneficial phytochemicals and antioxidants to support whole-body health.

  • You can start by adding more veggies to every meal. Try incorporating high-fibre vegetables like broccoli, cauliflower, kale, peppers, and spinach.
  • Substitute sugar-laden treats with low-glycaemic fruits like blueberries, cherries, kiwi, and raspberries.
  • Add healthy fats like avocados, olives, extra virgin olive oil, organic coconut oil and cold pressed hemp seed oil.
  • For those who choose to eat animal products, move away from industrially-raised meat products and start sourcing grass-finished or free-range meats and eggs as well as wild caught fish and seafood.
  • Add a few anti-inflammatory nuts and seeds and incorporate a diversity of healing herbs and spices.

Exercise – the most powerful medicine

Did you know that exercise might be the most powerful medicine to manage blood glucose levels and make your cells more insulin sensitive? Walking, yoga, Tai Chi, or similar more gentle forms of exercise are great ways to start.

Final thought

Obesity and Type 2 diabetes are closely related, and generally, increased weight increases the risk of disease. The correlation is not perfect but, nevertheless, maintaining an ideal weight, eating nutrient dense foods, and taking care of your gut flora are the first steps to prevention.

  • Broccoli vs Soda illustration adapted from The Blood Sugar Solution.
Mel Fourie is an AADP Board Certified Holistic Health Practitioner. She joined the International Quantum University of Integrative Medicine and holds a bachelor’s degree in Holistic Health Science, a Bachelor of Science in Holistic Nutrition, and a Bachelor of Science in Botanical Medicine. She later continued her studies to incorporate a Master of Natural Medicine, a Doctorate in Alternative Medicine, and now continues her research venture towards a PhD in Natural Medicine.

MEET THE EXPERT


Mel Fourie is an AADP Board Certified Holistic Health Practitioner. She joined the International Quantum University of Integrative Medicine and holds a bachelor’s degree in Holistic Health Science, a Bachelor of Science in Holistic Nutrition, and a Bachelor of Science in Botanical Medicine. She later continued her studies to incorporate a Master of Natural Medicine, a Doctorate in Alternative Medicine, and now continues her research venture towards a PhD in Natural Medicine. 

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The impact of sports drinks on blood glucose

Lynette Lacock looks at the impact of sports drinks on blood glucose levels in people with diabetes and offers healthier alternatives.


The origin of sports drinks

Sports drinks have been around since the early 1900s. One of the first commercially successful drink was Lucozade which was launched in the UK in 1927. Originally it was sold by a pharmaceutical company and primarily marketed to sick people. Today we have a large variety of sports drinks marketed to healthy active people. In fact, globally it is a (USD) $26 billion industry.

These drinks are designed to replace fluids and electrolytes that are lost while exercising. They mostly contain water, sugar (carbohydrate), minerals, electrolytes, vitamins and some also include caffeine.

What do they do for you?

During periods of intense exercise, you lose water and electrolytes.  Both of these are essential for your muscles to work properly. When you exercise for long periods of time, your body turns carbohydrates into glucose that your body uses as fuel. If your glycogen (glucose) storage gets low, you will become tired and not be able to perform optimally.

Using energy drinks can help hydrate you and provide your body with an energy source. However, these drinks contain an average of nine teaspoons of sugar per helping. So, if you have diabetes, this high amount of sugar can cause your blood glucose to spike.

Do you need the added caffeine?

Many energy drinks on the market contain caffeine as well as carbohydrates and electrolytes. The reason behind this is that caffeine has been shown to stimulate your brain by increasing focus, concentration and reaction time. The goal being to enhance your sporting performance.

The amount of added caffeine may be well-tolerated by a healthy adult but can spike blood glucose levels in someone with diabetes. The caffeine causes your blood glucose to rise followed by a spike in blood insulin levels. Caffeine can stay in your system for up to six hours prolonging this response in the body and causing havoc with your glucose metabolism.

Consuming sugary drinks with caffeine on a regular basis can put you at an increased metabolic risk and excessive caffeine should be avoided altogether in children, adolescents and people living with diabetes.

Do people with diabetes need sports drinks when they exercise?

As you exercise, your body becomes more dehydrated and blood glucose rises as your bloodstream becomes more concentrated. Adding carbohydrates will elevate your blood glucose even more.

If your drink also contains caffeine, it will make your blood glucose level rise even higher, requiring more insulin to bring your blood glucose levels back to normal. Overall, consuming these drinks when you have diabetes makes regulating your blood glucose very difficult.

So, to answer the question: no, people living with diabetes don’t need to consume sports drinks when they exercise. You need to look for a healthier alternative that hydrates and replaces electrolytes.

First and foremost, you must stay hydrated by drinking enough water. If you are exercising in the heat and sweating for more than one hour, you may want to replace lost electrolytes as well.

Everyone’s blood glucose reacts differently to various types of exercise and to monitor yourself effectively you need to be drinking sugar-free and caffeine-free drinks. Always check with your doctor before starting a new exercise regime and follow the tips below to see how your body reacts to the increased activity.

Monitoring tips when exercising

  • Check your blood glucose before, during and after exercising.
  • The first couple times you start a new exercise, check your blood glucose two, four and six hours after exercising because it can cause your blood glucose to drop, requiring you to eat more or lower your evening insulin dose.
  • Keep a carbohydrate snack on hand in case you experience a hypoglycaemia attack while you are exercising.
  • Drink plenty of water to remain hydrated while you exercise.

Healthy alternative drinks for people with diabetes

Sports drinks companies have already come out with sugar-free and low sugar alternatives. For example, Energade Light and Powerade Zero contain little or no extra sugar or caffeine but still contain electrolytes.

Unfortunately, most contain artificial sweeteners which don’t raise your blood glucose but do have other risk factors.  If you want to avoid artificial sweeteners, there are healthier alternatives. You could drink some of the following:

  • Unsweetened coconut milk (contains electrolytes).
  • Unsweetened fruit juices diluted with water (contains electrolytes).
  • Vegetable juice (contains electrolytes).
  • Kombucha (contains electrolytes).
  • Unsweetened tea.

You could also eat something that contains electrolytes and drink water. For example, a banana has electrolytes and you stay hydrated by drinking water.

There are other healthy sugar-free alternatives on the market. Ask your doctor or pharmacist which one is best for you.


References

https://diabetes.org/healthy-living/fitness/sports-drinks-impact-on-glucose-blood-sugar#:~:text=Caffeine%20(sometimes)%3A%20Many%20of,spike%20your%20blood%20sugar%20significantly.

https://www.nhs.uk/conditions/type-1-diabetes/living-with-type-1-diabetes/exercise-and-sport/

https://endocrinenews.endocrine.org/energy-drinks-cause-blood-glucose-insulin-levels-to-spike-and-hinder-blood-sugar-control-in-teens/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995988/

https://www.eatingwell.com/article/8009374/best-and-worst-hydration-drinks-for-people-with-diabetes/

Sr Lynette Lacock

MEET THE EXPERT


Sr Lynette Lacock received her Bachelor’s Degree in Nursing and Biofeedback Certification in Neurofeedback in the US. She has over 30 years’ experience in healthcare which has enabled her to work in the US, UK and South Africa. Initially specialising in Cardiothoracic and Neurological ICU, she now works as an Occupational Health Sister. She is passionate about teaching people how to obtain optimum health while living with chronic conditions.


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Siyabonga Kwanele Zuma – Tired of living a double life

Siyabonga Kwanele Zuma shares how he got tired of living a double life and now that he has shared that he has Type 1 diabetes, he is at peace and his glucose management has improved.


Siyabonga Kwanele Zuma (27) lives in Howick, KwaZulu-Natal with his family, including his fiancée and their six-year-old son.

Diagnosis

At age 11, I was diagnosed with Type 1 diabetes in April 2008. It was a random school day where I fell sick. My teacher took me to the school office and asked for my parents to be called to fetch me. My eldest sister fetched me and took me to the doctor. 

According to her, they could not pinpoint what was wrong with me. I was disoriented, so I don’t remember much of the doctor’s visit. My sister said as I was about to be diagnosed with the common flu, another doctor walked in. He asked what my symptoms were and once he knew, he suggested that they check my blood glucose levels. The results confirmed the second doctor’s suspicions.

The doctor then wrote a letter for me to be admitted at the hospital. I wasn’t on medical aid, so my parents took me to a public hospital. I was later transferred to another public hospitals where I stayed for three weeks.

Interestingly, my older sister also has Type 1 diabetes. She was diagnosed seven months before my diagnosis, in September 2007 aged 16. I call her my chronic twin.

Treatment

If my memory serves me correctly, I was put on Actraphane, which I believe is insulin given for free at government hospitals. I was on Actraphane for over a year, and I would get sick often.

One day in 2009, I was at my uncle’s house for the holidays. My glucose levels were uncontrollable; I think the change of climate also influenced that. One day I would experience hyperglycaemia and the next hypoglycaemia. I ended up being admitted to another public hospital in Durban.

My uncle was traumatised by the whole experience, as the hospital service was very poor. When I got discharged, he decided to put me on his medical aid, so I could get adequate help in managing my diabetes.

After that I consulted with diabetes specialists, who decided to put me on insulin aspart (NovoRapid), which is taken three times a day before meals, and insulin detemir (Levemir) which is taken at bedtime.

Since I’m not on my uncle’s medical aid anymore, I’m now on Isophane insulin (Protaphane) as it’s more affordable than Levemir but still take insulin aspart (NovoRapid).

Keeping my diabetes a secret

When I was diagnosed, those I went to primary school with knew that I had diabetes. However, when I went to high school, I decided to not share it with anyone. So, I would say I kept it a secret for 12 years.

The reason was I felt ashamed. I felt like it was my fault that I had it, and it made me different from my peers and all I ever wanted was to fit in. I didn’t feel cool which is what teenagers like being and I didn’t want to be judged when I did things my peers did, like drinking alcohol and smoking weed. Like I said, I wanted to fit in, and I did just that. Pushed by fear of missing out (FOMO) and peer pressure.

Tired of living a double life

Before my son was born, I felt like I had nothing to live for. Back in 2010, my doctor told me that if I don’t live a healthy life, I won’t reach the age of 21 with functioning kidneys, or even worse, alive. Hearing those words made me vulnerable to peer pressure and pushed me to live my life like there was no tomorrow, subconsciously. FOMO and peer pressure pushed me to rebel.

When my son was born, my perspective started to change gradually. I no longer felt like I had nothing to live for. I wanted to be a father that he would be proud to point out and say, “That’s my dad.’’

What also helped was my favourite artist, Kendrick Lamar, dropping his Pulitzer Prize winning album, DAMN. which made me develop a love for writing poetry. As time went by, I started writing poems about my life experiences and my ups and downs.

My writings made me grow tired of living a double life. As someone who loved and was inspired by Kendrick Lamar’s music, which is honest and authentic, I was doing the exact opposite. I was writing about my life hoping to inspire someone out there, but I wasn’t honest at all. I was omitting the most important factor that affected my life which is living with Type 1 diabetes. How can I claim to be a writer when my work lacks authenticity?

I wrestled with these emotions for over a year. Keeping my diabetes a secret proved to be detrimental in my life, and I couldn’t handle the pressure anymore. So, in April 2020, I courageously posted on social media that I have diabetes.

At peace with myself

I feel at peace with myself as I’m no longer in denial. Plus, I no longer have to worry about how I will take my insulin without somebody catching me do it. I feel so empowered because of that. My management has improved a lot. Before, I wouldn’t be able to say no to something I knew that I shouldn’t be doing because I would have to lie about the reason. But now with everyone aware of my situation, I can say no and give a valid reason.

Battling with flu every winter

Season changes are a nightmare for me. I struggle to control my glucose levels, as they are always up and down during these times. Getting flu doesn’t make it any better because it also affects my glucose levels.

Watching what I eat

I would be lying if I said I follow a particular diet. Even though I’ve had diabetes for 15 years, it’s only been three years since I’ve accepted it so I’m now gradually changing my lifestyle as I’ve found it quite challenging in many aspects.

Added to that, at the moment I can’t afford to be on a specific diet because my household consists of 10+ people, and those who can, contribute to buying groceries. A diet is personal, and I can’t expect everyone to follow my diet because I can’t afford it. What I do for now is to watch what I eat.

Love for poetry

My poetry book is titled Millennial Thoughts and it will be published sometime this year. I wrote most of the poems when I still had not accepted diabetes (2017 – 2020), therefore it doesn’t really focus on me living with diabetes. It’s more of a social commentary book, from a millennial’s perspective.

However, I do have a few poems where I mention my diabetes that I wrote post-acceptance. I’m also working on a memoir, where I’ll be speaking about my struggle with the negative peer pressure in my adolescence while also living with diabetes. It will tell how I managed to break-free from it and gravitate towards positive peer pressure, which led to self-acceptance helping me to regain the self-control I had long forgone for the fast life.

YouTube channel

Recently, I started my own YouTube channel which forms part of my journey to self-acceptance. As I’m a writer, that’s where the Living With Diabetes series on my YouTube Channel comes in.

I want to share my story in every way possible as not everybody enjoys reading. Some may not read my work but may watch my work. I want to grow my audience as much as possible, so I can share my knowledge about diabetes, and also learn new things about diabetes in the process.

A poem Siyabonga dedicated to his sister who also has diabetes.

CHRONIC TWINS

Our diagnosis threatened to make us the weak ones

But instead, it made us the sweet ones.

On some days, we’d feel bleak together

At the end of the week, we’d prevail together.

In a world full of unreliable souls

To me, you’re one of the few dependable

You are far from being expendable

You made an undesirable journey more bearable.

I don’t think I would’ve made it this far

If you and I grew up apart.

I want to impart that you are my star

My chronic twin, I love you with all my heart.


Connect with Siyabonga

YouTube | Facebook | Instagram | TikTok | Twitter

My sister and I; we both have Type 1 diabetes. This was in 2010 when I was admitted at hospital for a hyper.
My sister and I; we both have Type 1 diabetes. This was in 2010 when I was admitted at hospital for a hyper.
My sister and I were wearing blue in honour of World Diabetes Day 2022.
My sister and I were wearing blue in honour of World Diabetes Day 2022.
Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za

MEET THE EDITOR


Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on [email protected]


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